Understanding immigrants’ access to Child Health Surveillance Services in Portugal: a grounded-theory approach

Abstract

Barriers to adult immigrants’ access of health services have been identified: communication problems; health services' burocracies; health-care providers’ biases; low SES (e.g. Dias et al., 2009; Straub, 2012). Nevertheless, few studies have focused on immigrant children (Mendoza, 2009). This study developed a Grounded Theory (GT) on the determinants of immigrants’ access to Child Health Surveillance Services (CHSS) in Portugal. 5 focus groups and 10 individual interviews were conducted, including: 17 Cape Verdean, 12 Brazilian and 7 Portuguese caregivers, from heterogeneous SES; allowing the identification of common and specific determinants of immigrant and Portuguese caregivers’ access to CHSS. Data was analyzed using a GT methodology (Strauss & Corbin, 1990). (Not)Go to CHSS is the theory's nuclear concept. Its common main determinants were: perceptions of CHSS usefulness; consultation scheduling; vaccination as the perceived main activity of CHSS. Immigrants specific determinants of CHSS access were: degree of access to primary health care, related to (not)having social support and to immigrants’ legal status in Portugal; (cultural)differences in health surveillance conceptions. These findings may contribute to improve immigrants’ access to CHSS.